79 - This Leak Could Ruin Your Life: Every SSN Has Been Compromised

Show Notes

In this episode, Vic and Marcus discuss the Federal Reserve's potential interest rate cut, the turnaround in millennials' finances, the availability of hourly workers, layoffs in the retail sector, venture capital trends, healthcare financing, virtual triage, cyberattacks on hospitals, antitrust actions against Google, FDA clearance for digital therapeutics, AI's role in home healthcare, and advancements in quantum computing.

3:58 - Inflation Falls Below 3% for First Time Since 2021 NYT

5:18 - The Dramatic Turnaround in Millennials’ Finances WSJ

8:16 - Suddenly, Hourly Workers Aren’t So Hard to Find WSJ

9:53 - Macy’s closures will set off a wave of change at shopping malls CNBC

11:39 - State of Private Markets: Q2 2024 Carta website

16:08 - Healthcare fintech startup PayZen nabs $32M series B, $200M debt facility to fuel market expansion Fierce Healthcare

18:30 - MD Ally raises $14M for virtual triage Axios

20:02 - After health care attacks, tech giants will help small hospitals with cyber defenses NPR

21:55 - Hackers leak 2.7 billion data records with Social Security numbers Bleeping Computer

23:36 - U.S. Said to Consider a Breakup of Google to Address Search Monopoly NYT

26:42 - Google Play ‘Can Do Better’ on Faster Antitrust Fix, Judge Says Bloomberg

29:30 - CMS: Negotiated drug prices would have saved Medicare $6B last year Fierce Healthcare

31:11 -  WHO dec

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What is Health:Further?

Every week, healthcare VCs and Jumpstart Health Investors co-founders Vic Gatto and Marcus Whitney review and unpack the happenings in US Healthcare, finance, technology and policy. With a firm belief that our healthcare system is doomed without entrepreneurship, they work through the mud to find the jewels, highlight headwinds and tailwinds, and bring on the smartest guests to fill in the gaps.

all right we've been up to this week I'm back in the saddle good job last week when I was out appreciate it that was last week yeah that was last week you were on your own I left you and it was incredible really good job three weeks ago yeah and I was out of touch and so it was really helpful to actually get caught up with my own show that I was not part of oh it's good it's good well I'm happy I could be of service to you yeah how are you feeling you got injured yeah yeah the odds makers have been asking me like what's the how are you feeling yeah don't say anything um no last weekend uh Rachel and I were in Chicago I competed in the Chicago Open it was like a tune up uh cause world's just you know two weeks later right um it was good uh I I won and um faced face the guy who I faced in the finals of 22 and um great guy and you know he was really really tough in 22 and we both knew each other a little bit better this time so it kind of took some of the edge off and I felt I felt good about how I performed yeah so um and you beat him so yeah it's a he's a nice guy and much nicer in second place yeah yeah I mean somebody's got to lose right so you know um this time it wasn't me so anyway um yeah kind of getting ready for worlds which is which is good um hard to I mean I'm either sick or injured so that's just kind of but you know what I like watching the Olympics this year um so this is the first time since high school that I'm watching the Olympics and I'm a competing at yeah you know and it's one thing to watch it and just be like these people are so unbelievable like oh did you see what they did you see this did you see that and it's an entirely different thing to no like oh man they must be so jet lag oh you know yeah this person got sick oh did you see the the two golf carts that crash into each other like that's ridiculous you know yeah just knowing all the little things that um you know the whole Noel aisles getting covid thing yeah all the little things that go wrong and then that appointment will still come at the right date at the right time and you have to walk out there and perform period end of story like and yeah I thought about it I forget his name there's a male US gymnast really charismatic guy from Michigan I wish I knew his name but he did well but he brought his own bed because he he was saying that I'm gonna be in the Olympic Village I don't know what's gonna be like and um sleep is mean you need to sleep you need to recover it's a big deal it's a big deal yeah and the gymnastics was really grueling it's kind of like day after day yeah right um so anyway I I just I had so much more appreciation for it this year and it was also really inspiring because I'm leading into worlds and like it's crazy man everything is just I got sick twice this summer you know now I'm like injured and it's just you know but that's that's like that's what it is part of it yeah that's what it is right you know so anyway and we talked about Steph Curry just for a second he was lights out is in and they actually had a little bit of competition which was great yeah yeah I mean to make it fun yeah that's what I mean to make it fun until he decided he decided okay okay we're done yeah yeah uh man that guy is the greatest pure shooter I think ever yeah ever um the range and some of those in the bucket yeah he's just like double teamed out at the mid court and he's like right now yeah and like just swish I mean perfect yeah he's he is he is something special all right man we got a long show because you found too many stories so let's let's let's dig in alright uh big news on the inflation front it fell below 3% for the first time since 2021 yeah so it's great it's been bouncing around at 3 ish and we got down to 2.9 and so really positive we had a you know hard jobs report was that two weeks ago a little while ago and so I think this is the kind of seals the very likely case that the Fed will cut their next meeting which is great we're all waiting for that yeah did you see Joe Biden uh talking about uh I I like non running Joe Biden yeah he's a little more free yeah he looks better oh yeah I'm sure he's got more sleep he looks like he got five years back yeah for sure um but he was somebody was asking about his economic policy and he was like yeah it's a soft landing like I told you start writing about it and I was like good for you gentlemen you know like I like that he's he's talking with a little bit more reckless abandonment yeah it's pretty cool um yeah so look this this is uh all leading up to September right I mean we're gonna track week to week just to see what the landscape looks like when we hit the F O m C September window yeah I think most people are the stock market will front run it so now it's sort of like people are expecting it it's like 100% yeah yeah so whether it's 50 or 25 is the real question that's right that's right um alright this is a great story that you found in the Wall Street Journal the headline is the dramatic Turnaround in Millennials Finances and we've heard forever that the global the great financial crisis destroyed the millennials and they entered the workforce with no prospects and yeah they're all behind they can't they can't buy a house they can't get married they can't do whatever everything's terrible for millennials and the Wall Street Journal has this article that it's been a huge turn around and so in the last uh since the pandemic really um the millennials have in in changing wealth and so if you if you're not watching this uh in video first of all you should but we'll kind of describe it the millennials of course are younger so they don't have as much wealth as other generations but the growth during 2020 to 2022 it's it's probably 200% growth yeah and it really uh the article talks about there's a class of millennials that purchased a home before the pandemic right and there's a class that that didn't get around to it didn't didn't do it for whatever reason and that really has sort of separated into two two cohorts because the real estate prices and the and you know probably many of those people also had a few stocks and investable assets that's right that's right and both of those asset classes real estate in stocks and bonds just exploded in all the pandemic you know craziness yeah so this this graph shows that from the first quarter of 2016 to today um millennials have outpaced every other generation in uh change 300% change now they were starting from a lower base right um but we're talking about less than 10 years to 3 x yeah that's incredible as a as a as a generation the whole generation with a lot of people in there yeah and and knowing like a whole bunch of people are dragging that down you know especially the ones that were not able to buy houses in the 2020 window right we talk about the K shape economy all the time on the show and it's it's real that sort of a cross generation yep based on do you own a home do you own stocks um because that's where the the booms have been yep um but it's great to see the millennials uh catching up and maybe into the growing faster than any other generation yeah hopefully it's that's we're we're gonna be able to end that narrative yes um cause I I look I I feel like the millennials are quite frankly they're they're getting pretty old yeah you know they're in the mid thirties yeah and then they have caught up I think a lot of them are starting to have kids they have houses I think the narrative is is should be over it's still being trotted around but I think this story it surprised me but uh but that's why I wanted to bring it up because I think we should pay attention they're starting to do well yeah which is good which is good another story in the journal headlines suddenly hourly workers aren't so hard to find this is a little bit more color on the recent jobs numbers and the unemployment rates that we've seen over 4% but we all remember coming out of the the pandemic every place if it was a retail storefront had a big we're hiring sign and it was all the stories about you cannot find hourly workers now we knew that there were you know stimmy checks were still out there and people were sort of taking their time but now the tables have turned you know it started with the tables turning on the white collar worker we had quiet quitting you know during the pandemic and then it was like oh I lost my job and I can't get a new job but now the hourly worker is finding themselves in a bit of a pinch as well yeah and that's the reason I think the Fed needs to start turning to really trying to get back to full employment it's a they're starting to be I think some pain in the hourly workers not able to find jobs unemployment rate is ticking up it's not huge but it's ticking up about four and there's not as many open jobs anymore so there's a chart in here that the open jobs she's declining pretty significantly on a month by month basis yeah yeah and it's mostly affecting every job segment but primarily the lower the lower income retail manufacturing the hourly worker roles yeah and and look I mean one of the big themes here is uh downsizing layoffs yeah right um so a story that caught my eye this this week uh was in CB CNBC they covered that Macy's is going to close 150 of their stores by early 2027 and I think that accounts for about a third of their stores so that's you know apparently it's less than 10% of their sales but it's 25% of their gross square footage so there's two stories here right one is a corporate real estate story right I mean malls you know not quite the same but it's it's real state these assets are yeah and it's it's hard to repurpose that that's right they're talking about things they might do but but those are not gonna create the same kind of job growth or economic growth no no so there's a devaluing of the asset but also hourly jobs you know Macy's definitely a lot of workers at Macy's a lot of workers at Macy's right and and you feel like a Macy's has a lot of sort of satellite things around it yeah um so yeah it's it's these down sizes and these huge layoffs that are that have been happening and compounding over the course of the last two 3 years we see these things as okay they're happening to companies but in accumulation over the course of multiple years it starts to be a whole workforce issue and I think we're now finally starting to feel and see that yeah and it's I'm not sure the Fed can really change that very quickly no so they need to not get too far behind that's right yeah yeah I mean whatever we're seeing now it's probably rolling out over the next 12 months and that's not stoppable right yeah so I agree I mean we need to start to change direction now yeah totally agree with that all right moving into VC uh Carter came out with their state of the private markets for Q2 2024 and uh thank you Carter for producing this state of the private markets in particular because finally we're getting some decent news in the venture ecosystem it feels like we have flushed out all the bad deals it feels like all the founders have capitulated it feels like all the down rounds in the paper play has happened and we're now reset the books you know probably by the end of last year everyone took their medicine before their audited financials had to come out and now here we are 2024 and we're now starting to kind of see fresh deal making starting to happen it's not happening on the break neck pace but it is it does feel like a reversal of the trend yeah I think that's right every key component so the number of deals the evaluations the time to graduation or the next round all those things are getting better and I think it is I think you're right it's with flesh through a lot of the a lot of the bad actors of the negative things or people kind of holding on with not the right business model and too many employees that's all kind of gone now and it listen it's never easy to raise money even in the boom times it's not easy to raise money that's right I don't think it's easy today but high quality companies are getting financed and that name we need that that's that's healthy and and it's great to see it like come through in the reports yeah yeah and and I mean especially great for those companies that were able to hunk her down figure out how they were gonna make it through the winter um that we just went through I mean I I'm not sure it it does feel like we're entering spring in in the venture markets I mean I I I don't wanna call winter over quite yet but we are starting to see some a rounds and some B rounds starting to get done now here in the third quarter um and it just doesn't feel like there's that same level of desperation and it also feels like a lot of companies figured out how to lower their cost of operating lower their burn and get more focus on their PNL so yeah if it if it changed the behavior flushed out the bad you know the weak hands and made the strong company stronger we should have a really nice rebound coming out of this yeah I think that's right in the um when we talk about AI every week here that the creative destruction is is hard to go through I mean like but now you're starting to see most businesses have figured out a way to reduce their cost and increase the way they can deliver for customers even it usually it's not even an AI product but they're using artificial intelligence to do more and higher quality work with fewer employees and less cost yeah and that was a hard process to go through and it's painful but but I think we're now seeing the other side of it we're getting much more much more efficient uh startups that can do a lot more with less money I I one of one of our portfolio companies has through the hard work figured out how to get their burn down from it was you know up north of a million a year um to where it's that I think their their net loss next year will be around 75 k which basically means your capital policy at that point and all the changes they needed to make to get there those those were painful yeah right changes um and there's real there's real people that changing their job or they they cut staff or in my point fully I have all of those yeah it was it was so hard but I'm telling you we went through that budget reforecast meeting and it was just like wow like this company basically controls this destiny it just needs to work on working capital now you know what I mean and and you and and now so empowering value creation starting to happen right um so I I know I know that that company is not the only one who went through that process right many others went through that process and so uh I'm excited for those companies because on the other side of this there's gonna be capital looking for who who clean up their house who got fit you know yeah and we're starting to see that in this Carter report there there's a lot of capital on the sidelines it's like looking for the opportunity that's right and it's starting now to pay attention in this great companies out there that's right uh speaking of uh deals getting done pays and nabs 32 million Series B+$200 million debt facilities to fuel market expansion so this is a healthcare fin tech startup that is by now pay later uh in the healthcare space and uh this round was LED by NEA 32 million uh other investors are 7 wire single fire uh Viola and others um Vic what what did you take out of the story yeah I I'm it's great to see that the by now pay later option being being brought out there I mean it's in a lot of other spaces and healthcare is very expensive and I think in general people want to pay a fair price for healthcare but it's difficult to to make that huge one time payment and so a structure where you can pay over time at reasonable rates I think it's great well there's that but there there's also like how does this work right so it's it's a part of it is the the cutting down the amount of time it takes for the provider to get their their cash yeah right um in the buy now pay later space for the retailer I mean the retailer just basically treats it like a like a marketing expense you know that's that's how they make the money because the consumers paying the same amount of money right often it's like 0% for some amount of time right okay so who finances that and who loses who pays the retailer pay is the buy now pay right pay later company um sort of for getting access to the cash right away while the that company takes on the risk of you know holding them yeah and we and we know that you can negotiate with providers exactly exactly most people listening know that but most patients don't know that that's right that's right and so this is a great way to say to the patient we will allow you to pay this over time which in reality is not that hard to negotiate but but it's in a structure that they're used to and it's a I think it's good yeah and and look I mean you're taking away the the business of managing credit risk from a provider yeah not very good at it to an organization that's dedicated to doing that and for the provider you just get your money faster right so this is actually something that really does make a lot of sense um and and probably should be scaled out beyond just this one company alright uh next story here MD Ally raises 14 million for virtual triage so uh a couple of friends on this deal um shout out to Toyo Louise from say adventures who was in early on the I think seed round of MDLI Catherine and I looked at this deal we were too late to it it was during a pandemic when I met Chantelle and she was Chanel and she was already like I got money I don't need your money yeah yeah um and now um Derek Dedicar at uh at first Chrissy um LED this round and so congrats to him and I'm just happy for them and sad for us that we didn't do yeah get to play in this round cause uh this is a great company really great company they they focus on basically um optimizing 9 1 1 um you know the the the that process of triaging where um where you should be routing that call so it doesn't fire up an ambulance if that's not actually the best yeah you know if it doesn't if that's what they need yeah that's not the best resource that they need um triaging that that's a that's a big deal um and so there's a lot of things in the medical dispatch and response system that can be optimized through technology through triage through care navigation and that's what MDLI does really really smart business um saves a lot of money saves a lot of headache I think also delivers the right care to people when they need it and when they most need it in an emergency setting so great business happy for them for sure yeah so moving into policy but I think also just talking about cyber attacks yeah um we know that we have an epidemic in cyber attacks and hospitals in America at this point everyone gets that um but who's helping them with I think has been our question right and we're learning that actually some of the big tech players are now pitching in to to assist yeah so the largest hospitals and the largest payers we've had stories of very large on both sides being attacked success you know successfully for the attackers and the rural smaller community systems don't get the same kind of press but they they are not able to offend off these attacks right they get attacked a lot and so Google and Microsoft have both agreed to and in some cases they're doing it for free in other other times it's a 70 80% reduction from their normal billing rates to come in and provide cyber security tools and resources and consulting advice for these health systems which is great the Biden administration kind of coordinated this effort and NPR just sort of highlighted I think it actually happened in July I've missed it but they have a couple health systems that you know it's really helpful and they're talking about how valuable it is there's some concern about will it last long enough but I'm less worried about that I mean they need help today and what they need in three years I don't know but but I assume the big tech companies will be there then too I mean it's not it's a good PR move for Google and Microsoft both of which need PR yes and I don't think it's that much effort for them to do it no no it's it's it's a it's a positive story and what has otherwise been pretty really a bleak yeah right set of stories right speaking of bleak you found this this story on bleepingcomputer com hackers leak 2.7 billion data records with Social Security numbers so that's all of us yes it's the entire population of the United States and the reason it is so many is many of us like for me sometimes I'm Vic Gatto sometimes I'm Victor Gatto sometimes I'm Victory Gatto those are that's three different people right so but it's basically if you're listening to this your name address Social Security number is out on the dark web and is being sold and probably several different versions of your name and different addresses you have and it's already out there yeah and there's not much that we can do about it um I mean this all really kind of went down in a bad way when Equifax got hacked right yeah that was kind of like the beginning of knowing okay yes that's the honeypot yeah yeah this was a different company but same same space background checks and credit scores they had aggravated everyone so she could they had all that information and they got they got stolen from them yeah yeah so look I I think most of our listeners are probably already doing this but you should have credit monitoring and um you know dark web monitoring yeah my credit score is frozen you you should you should have your credit report locked yeah like you just you just have to you just you just have to at this point because all our stuff is out there you can't think your stuff is not out there that's right alright this has been a big story uh Google now really squarely in the crosshairs of antitrust suits and the judges are starting to move in the direction of saying Google is a monopoly and I think everyone's known that for a while but now we're we're we're starting to get some some validation on that fact um it does not feel like we are going to move aggressively into a breakup phase it seems like everyone wants to be very thoughtful about this and about how we reconcile the fact that Google totally controls the search market um but it seems that there's no longer a question that Google is a monopoly yeah I mean it was it was found in a court to be a monopoly in search and the remedies is what the court calls it like what we will do about it is gonna be decided in early September yeah um I think the big thing that is being pointed at as where they are wrong is the pay the apple payments and other payments yeah but the apple one the apple is the biggest one 20 billion a year yeah for apple to put Google as the as the default search yeah and I think and Google decided to position that as profit sharing yeah right right yeah and I think um what was interesting is in the some of the testimony people from apple said well if we didn't do this with Google we just wouldn't do it at all yeah uh but the fact is that they they took the money and they did have done it for several years I think it's um I mean this article in the New York Times is talking about the Justice Department considering breaking them up I don't think that's real I agree with you that no that maybe the just rose considering all kinds of stuff but I just don't think the discussion about breaking YouTube away from search away from Android is gonna happen I could be wrong but I I've talked to a couple people that like study this stuff and they think it's not realistic and I think the the payments are gonna stop and it's gonna be now a free for all of of what search engine does apple wanna put on there yeah yeah um and I don't know I think I think it's I'm sure Google might lose some a little bit a couple of points a couple of points but apple shareholders mean they get 20 billion yes of like 99% free free cash free cash and I haven't looked recently but it's like a significant multiple on their earnings and so it's gonna be also negative for apple so do you think buffet was tracking this this uh suit into the math before he dumped uh half his position I don't know I maybe maybe um I'm not sure why he has moved to sell his apple position but that certainly is maybe a factor in it Google is also sort of losing in their Google play app store epic which is the game maker behind Fortnite and many other very very popular games they've largely been known for their suit against apple just all of the 30% taxes that that apple does all the lockdowns of what you're able to do in your app in terms of like an economy and doing transactions um all of those those things that apple has um locked in in their App Store epic spin at war with apple over those things but um apparently epic also went to war with Google over the same things most people don't think about the Google play app store that much um and apparently Google lost and the changes that I guess they they needed to make to open up the ability for app makers to operate an economy inside of their apps that are deployed via the App Store um this Google said it was gonna take 12 to 18 months and the judge said no your Google you can do better than that you need to do it much faster yeah I I think the uh that's right and the the strategy deployed by Google and apple was very different yeah apple said okay you're right we will create a wait for you to do transactions outside the App Store and then they charged the charge the same for that that's 29% and the app store is 30% which you know it's ridiculous but bro kind of brilliant Google I think took the attack that Android has multiple app stores right and there is customer choice which is legitimate which is true and I have an Android phone and they thought they could win and I think where they were wrong is just the the misunderstanding that the facts were not the the facts were not the point no it it was to try to somehow make it more fair broadly and the fact that there are several app stores that doesn't matter and so just attacked the strategy and the tactics around the legal case apple did a much better job they had a harder case but counterintuitively that made it easier for them to figure out a back door I think the thing between these two stories is Google is now becoming synonymous with monopoly yes Google is in trouble from a regulatory at least public perception and and and they're gonna be they're gonna be under the crosshairs to figure out some way to make it more competitive to the problem is that there there is no search that can compete with Google no no so I don't know how it's gonna change very much but but the government's gonna try to do something CMS is saying that negotiated drug prices would have saved Medicare $6 billion last year so they came out today with the 10 is it 10 the list is on here the 10 negotiated prices for the 10 drugs that they negotiated and there obviously there are significant savings and so next year these prices will kick in and the federal government will save you know roughly $6 billion next year um it's not true that that will be passed on to Medicare or Medicaid no participants no the federal government's gonna save money um I I'm in favor of it I think it's I think it's good to do I don't know why 10 is the number maybe it's because it took took them you know eight months to they started in in the first quarter they started in February so maybe if they had done 15 they would never have done in a year um but at least they're trying something yeah I mean they they they took 10 I think they try to take the 10 most used um it was some algorithm of the most commonly used and the highest price yeah like so it's the most cost to the federal government yeah and then when we look at the who who the farmer companies are between the 10 no pharma company represents more than two of the 10 so I think that also probably gives you some diversity and make sure you're you're appropriately spreading the love if you will yeah love or anti love right yeah um alright so not so great story monkey pox outbreak has started I'm I'm not sure if it actually started in Africa but it has really gotten serious in Africa yeah we've lost control of it in Africa or or it's a serious health emergency w H O has declared a health emergency in Africa yeah yesterday yes and I I want I want to make sure like I found the the numbers here because I remember seeing that there were over 500 deaths yeah this year from it so that's that's pretty serious yeah um many of the cases that have been reported this year more than 14,000 with over 500 deaths uh largely in the western part of the country yeah yeah and and it's um I mean 500 people dying is terrible and I think it is we need to try to get control over it but it's so it's good that they've declared emergency I think that unlocks a lot of money and resources and support um to try to stop it yeah and and by the way those numbers were for the Democratic Republic of Congo so that's one country that's just yeah but that's the worst that in South Africa the two worst okay okay uh and then apparently now there so that was yesterday yesterday yeah and then today two hours or three hours ago so we're recording on Thursday the first case in Europe was detected Swedish Sweden traveler coming from Africa hmm and so maybe not that surprising no but you know we're all scarred by the covid pandemic we're just a global interconnected society so our thinking that we're there's gonna just stay in Africa is not realistic yeah and um the last time that we had a flare up of monkey pox there was a shortage of the vaccines so there's the whole shortage issue but there's also the whole vaccine issue cause now now we've got like a very big vaccine trust issue yes uh in the world but certainly in America uh very very big vaccine trust issue so I don't think those two things overlapping is is great for um it's terrible it means outbreak the lack of trust in our health care institutions it is really dangerous and I don't know how to roll back the clock I mean it there's a lot of reasons that people don't trust but but at the same time if we don't trust the World Health Organization to to tell us about the global pandemic risk I think we we're in trouble so it it's sort of a it's not good in either either case yep agree alright so I talked a little bit about this last week uh when you weren't around but uh this whole Etna thing uh with CVS is starting to take more shape so a group of employers uh are suing Etna claiming that the you know their their pay rates are inflated unduly inflated um what what what's all going on here you know CBS is framing it as you know the leader was not meeting expectations but very quickly now we're starting to have suits coming out against Etna as well what how many stories have you read on this on this situation I mean I've tried I mean I've read probably five different stories yeah there's not clarity on where this is all headed it's it's a train wreck like it's not good the merger that had a lot of promise yep clearly has not gone well and um Karen Lynch has come over come in to lead the whole thing they're not replacing no Brian Kane as far as I know they haven't they haven't named a replacement no um and it just seems really like a mismanaged um CVS and Etna are both wasn't a merger of equals but they both were very large yeah and I don't think the Etna side really has been managed very well it seems like it seems like that it seems like that I mean I mean those those seem to be the statements coming out from yeah from CVS yes right until um I don't know it seems really difficult given CVS has a lot of issues in its in its retail store right platform right too I mean there's issues all around um with CVS and Netna and a lack of management and even like control over the various divisions it's not a good thing no alright our friend Clay Richards who is an operating partner at Clayton Dubilion Rice he is taking the helm at a new platform called Mosaic Health and they're taking the a pre health asset which was actually a combination of Vera Whole Health and Cast Light and they're merging it with their millennium of position a position group asset which was a position group that I think was largely in the um it's a primary care asset largely in the Florida area but they were very good at um I can't remember if it was employer or if it was like Medicaid that they were really really strong in um but basically Clayton Duvaliers is now integrating all of their assets and their partnering with um elevants slash Caroline uh on taking this primary care platform out to the market yeah um that's that basically the summary what I know I think it is um I think Clay is a good operator and it there's a lot of advantage in putting these things together and I think it has a lot of promise like stitching them together and being able to share information and manage populations people from the primary care advanced primary care kind of point of view can be really powerful um not a lot of new things as far as I can tell it's more like they're integrated together and it's it's it's integrating it and aligning it with a very very large payer with with ambitions right you know and moving very quickly on the pay vider side yes yeah so I it seems like it really promising but but I know sort of what you described all right this story you found and Wall Street Journal the headline is hospitals do push treating patients in their homes I mean I think you and I know this is not a new push not a new push remember when Travis Messina launched yes in here in Nashville um the thing that caught my attention is that it's much more widespread this is Mass General yep um doing it in Boston area but this the story talks about several hundred health systems that have these initiatives and it's it's evolving in a way that is um hard to fully get my head around but when contest a hospital home was there was a lot of infrastructure that was brought into the patient's home yep and it was pretty limited in the number of like um patient eligibility was pretty limited yeah you had to have a certain set of very specific protocols yes and they were pre defined yeah and there was a usually a hospital bed and diagnostic machines and a 24 hour nurse often um and what is being described here is not that it's it's whatever care the patient needs delivered to their home but much more flexible set of options so not every patient needs all the diagnostic equipment and a 24 hour nurse some do some don't and I think that is on one hand really attractive like if we can make the patient not everything is ICU yeah right if we can make the patient get to recover in their home yep with their family and pet the pets is a big piece and their loved ones gonna come to visit them easily yep not have to go to a new place that's maybe hard to find and not where they can easily come by after work that's a net positive that's good thing that is good but this it seems to be a lot of questions around what patient populations are eligible for this and what services would fit and a lot of the description in the story sounded much more lower QD more like home health set of services and equipment meaning very little equipment right and you know hold up your iPhone to talk to a DOC if you need to get a DOC's opinion on something and well that's maybe gonna be a more efficient way to do it also opens up lots of opportunity for billing at hospital rates for what really is a home health service and I couldn't find clarity and in fact in the article is a lot of discussion of regulators having concerns about the trend line and so yes not a new story but the the scope and scale and the sort of diversity of patients that are being treated seemed worth mentioning and I think what's really interesting is that patients will want this oh patients definitely want it right um so I I kind of think in hospital wants if you can build in patient rate well of course but but I guess what I'm saying is from the regulators perspective patients want it I I say that in the same van that I would say consumers want it right like it it it doesn't mean that regulators won't act aggressively but um it does create a little bit of a headwind for regulators when it is something that the public wants right if like if it if it's not politically popular to over regulate this thing that is popular with and let's let's be honest right most people who are gonna be eligible for this are gonna be like Medicare yeah right recipients right which is a really strong voting block strong voting block and they're not paying no and they're not paying that's who and they're not paying I mean let's take it to the extreme we could mean home health care is a hard business yeah we don't reimburse enough in my opinion no and we should reimburse more and then have home health responsible for visiting more and providing more services yes and there's a is an opportunity I'm not saying that that uh mass generals doing this or anyone's doing this but there's an opportunity to to sort of have reimbursement for really hospital services but deliver let's say a more higher service level home health kind of care right and if we want to do that I would be in favor of that sure but we should you gotta do the work we should talk about it and and get some kind of new reimbursement code yeah you gotta do not just pretend like it's hospital at home if it's not right and right I don't I think you're right the patients will like it the hospitals like it the healthcare workers like it sure everyone the only person doesn't like is the taxpayer who doesn't even know right and so yes it's gonna be it's gonna tend to have no one on the other side talking about it yeah and you know if we wanna fund that as a society that's great I might be in favor of but we haven't decided to do that we're just sort of doing Tommy Hospital yeah all right here's another kind of unorthodox thing happening at hospitals Northwell Health has built a production studio a movie studio on their facility and they're going to develop documentaries films and TV shows yes and I I don't even know I don't know why this makes sense but they have they already done it and and they're they're they're doing TV shows and documentaries if they wanna do marketing in PR that's marketing in PR but producing TV shows for Netflix does not make sense to me but hold on the very first full paragraph in this article says spurred by the success of documentary streaming on Hulu Max and Netflix that have been set at Northwell Health's network of 21 hospitals and hundreds of clinics across New York City and Long Island the system recently established a production company of its own to work on more projects so they've run some pilots of this and the Ducks are already on the big three streaming platforms I I I know I know and I don't think they have any business doing that haha I mean well look I mean it's not it's not an entertainment studio no but it's a committed is which there's what they're creating yeah but but it but it's a it it is a communication uh medium right and I think I think what would feel savvy and and real especially in a time where you know we want to talk about entertainment I mean the media industry is collapsing in front of our very eyes yes and and you you were in the media business before but like you know so is is no surprise to you this thing is collapsing right before our very eyes right now right and I mean WBD Paramount I mean yeah you name it they're just getting crushed and part of why that's happening is because we have distributed the ability to produce to everybody and we've distributed channels everywhere and it now feels more I mean look look at us we what did we do you know what look if we were to ask our LPs should Vic and Marcus build a studio in their office how many of them would would say yes no one would say yes they would all say they have no business doing that right right but like we have become much better investors because we have a studio in our office and we do this show right so I kind of think about that the same thing here and I just generally think this is the world like we're gonna have production studios everywhere nowhere is gonna be off limits for it because you have to control the medium of communication about your business you have to you can't rely on PR you certainly can't rely on it on the incumbent media ecosystem to do it I mean they're always gonna get it wrong so you gotta be out there communicating your own brand the way you think is best I think I agree with that I think you I think we should and health system should communicate their brand in the best way they can and I'm also in favor of letting people see behind the scenes and showing that doctors are people too and nursing people too and they're trying their best and unfortunately in healthcare you know not every patient survives and it's hard and and really important work I I'm in favor of that when they try to say they're gonna create a production studio as a revenue center and it and it's gonna be part of the strategy like I don't I wanna have a lot of listeners to the show and I don't think we are gonna start selling ads no no of course not of course not I I I I think any revenue that they are going to make has to be thought of as offsetting expenses and maybe a little bit of cream I think the primary thing and look they're in they're in New York right that's actually a pretty competitive ecosystem yeah from from a health system brand perspective if they can make sure their brand the Northwell Health brand is the brand across the top three streaming platforms that's gonna and that's that is likely a marketing investment worth making right yeah that is likely to drive top line volume uh against against their competitive brands so to let me just quickly say like we used to run an accelerator and there was a point in time when people wanted to come in and film our accelerator yep and I was allergic to that like I don't think that would think that would be negative to the effort of helping a company grow yep and detrimental to to the mission and so if they are showcasing the great people at Northwell and using it as marketing and PR I'm in favor of that if they're trying to create a drama new er um I just don't think it makes sense yeah yeah let's let's hope they're not trying to make a new er yeah let's let's hope big drug makers are clinching smaller deals so this is talking about how the large farmer companies are now focusing on targets that are 5 billion or less um seems to be a couple of storylines here one regulators have been crushing the big deals and so do the small deals that you can get in under the radar the other one is biotech's been hurting and they are trying to sell their assets and lower prices are easier to sell so seems to be yeah probably both yeah little bit of both the story is skewed because the Wall Street Journal and they are trying to pretend like everything is great if the regulators would go away right of course that's just their stack yeah um it's slanted mostly to the regulators are looking really carefully at anything over 5 billion I think there's truth to that sure but there's also truth to the fact that the biotech uh kind of growth community has fewer assets that are worth more than 5 million and the farmer businesses need every revenue they can get so like they're willing to look at smaller deals that's right there just aren't that many people to choose there are there companies to choose from that are really impactful um so I think it's probably some of both but it it does mean that the the overall industry is not able to sort of grow at the same pace right whatever the underlying reason is I think you're not gonna see those mega blockbuster deals as often yeah and and to that end we're now seeing Roach considering the sale of Flat Iron Health yeah unwinding big unwind yeah right when Roach brought Flat Iron Health to me that was like one of the one of the capstone acquisitions of a pharma company getting into digital health getting into data and it wasn't the only one many of them you know Astrazeneca yeah made their whole platform that they were gonna do from a digital health perspective but it was it was sort of this this was doing a bunch of stuff it was this wave of farmer saying hey we're gonna get into digital yeah digital data extending away from about chemistry and physical you know pills on the shelf yeah into digital solutions yeah a little bit of like kind of a conglomerate mindset right yeah um and now they're talking about unwinding it their their position on why they're doing it is that they've actually hurt flat iron because since Roach has become the acquirer even though flat iron is a separate business other farmer companies are less willing to work with flat iron because they're under the Roach umbrella um which I'm sure is actually part part of what's going on here um but there also could be something about a we just need to tighten up our ship and not do this conglomerate thinking and let's just yeah pharma company yeah I think it's partially that that could be pretty easily fixed by calling a couple competitors and doing it doing a deal with terms that that are clearly not you know negative to those companies sure the more made me less good for corporate public relations but I ignore true is they need to find the money and they need to focus on their core business and it's a new executive team that this isn't their deal and so I'm sure they looked at like we we they bought it for 2 billion they probably get 2 billion right um and they could use that money and focus and and what do we want this thing for I think that's more what it is that they're trying to spin yeah yeah I think that's right uh Big Health clinches FDA clearance for its digital therapeutic for insomnia Sleepo Rx so haven't heard about Digital Therapeutics in a while I was glad to see you bring this up yeah um FDA clearance is good now you gotta get CMS to pay for it yeah and apparently Big Health thinks they're gonna get CMS to pay for it inside of the next I think I think yeah the next 90 days 90 days okay so this this is one where I just wanted to make sure we started a conversation about it to track and see whether or not they get it uh through CMS and they get it paid for if they do then my question goes to is it because of of the fact that it's it's sleep and sleep is something that you know we're not really tackling very aggressively on the pharmacological side so we are looking to digital you know solutions to help people with their sleep and we're we're now more than ever realizing the importance of sleep in overall health so it has nothing to do with the specific thing that that because healthier or is it where we're open to digital therapeutics right yeah the reason to track this is is the ladder you know I I like sleep I think sleep's really important and I have an investment in sleep stuff not this one um but the reason I think our audience to track the why I wanna track it is if we can come back to Digital Therapeutics I think they actually are there's a lot of effect I mean they're they're effective so many benefits a lot of benefits and we should reimburse we should figure out some framework to do that um and it's been dormant quiet for gosh 18 months yeah and so um I'm hopeful that that they make it for a bunch of reasons I mean it feels like the dust is settled we're long ways away from pair right right and it does feel like we can start to kind of re approach this right like let's let's let's get some stuff through the pipeline let's get some stuff paid for and let's see how it works out and look we're gonna we're gonna you know the next show we're gonna publish is our our six month check in with TK yeah from Virtua and it's a digital therapeutic effectively right I mean you know so yeah and he's has great results so um yeah I'm hopeful that they will start paying for these things yep all right uh speaking of DK uh striker continues their shopping spree with the acquisition of smart hospital developer Care AI so these are friends uh Bruce Brandis is I think the president at Care AI and uh so congratulations to Bruce and and the team over there um striker sort of maker of beds and uh other things that happen in the hospitals all kinds of stuff and Carrie I is kind of their their big move to transition their their their position in the market from just being a provider of beds and and related devices to the full smart hospital room yeah that's right and um I mean we talk about it with TK as well because it's AI and he knows this we know everyone knows they are on a call with TK knows this space it's a great move for striker and I think good for Carrie striker also owns Versailles the voiceover IP piece and when you stitch together Carrie and Versailles and strikers existing you know physical things like beds and equipment it's a pretty powerful portfolio of suite of tools and in in a really interesting way outside of the the sort of lockdown of epic concern yeah which is which I love to see oh yeah I want someone to like keep them honest and force them to do something yeah and so I don't even care who wins just the fact that they're now there's gonna be competition will be good agree headline of the story of the New York Times ALS stole his voice AI retrieved it this is a profile on the second Neuralink patient yes and it's a great story we'll put the link in the show notes um ALS is terrible it also has progressive disease it's you know fairly slow so he knew he was gonna lose his voice and you know read the story to his daughter and all this really kind of you know emotionally hard things and Neuralink uh it's the second patient Neuralink has restored his voice which is incredible and really just positive for humanity that we can do this it's you know it's only a second patient but it's the second successful patient out of two and I'm excited about it yeah it's it's it's really good it's a big deal I I love Elon the engineer yeah yes so stay out of politics I'd like him just get off axe yeah just give it back give it back to Jack uh Vivid Health brings generative AI into home health care hospital home services so this is uh kind of a care navigation care planning L m that interacts with patients accesses their listens to them but also accesses their record and helps to basically navigate what they should be doing at home what kind of caretaker set up they need etcetera etcetera yeah so I think we have progress beyond uh covering all the back office things AI is now I think accepted mean people still adopting it but that's right that's not novel anymore they are using it in developing care plans and interacting with patients to and they change the what you do tomorrow with the patient yep which could be incredibly valuable yep and it also you know the clinical side of generative AI has lot more opportunity but also more safety things to think through um but it's and then it ties back to the the home health care and hospital at home they're merging the two together yep um because they probably don't see much of a difference between the two right right all right final story I'm gonna let you take this one man quantum computing people been talking about quantum computing it's over my head technically but basically instead of ones and zeros you get all all grades from 0 to 1 including point five and everything else in between so a lot more um complexity also a lot more power it is hard to manage the quantum bits in a way that's useful so I think for a long time we've had quantum bits we couldn't really do much with them and this story which is in Tech Crunch is saying that in the next five years there will be an ability for quantum computers they can't do everything but they will be able to d decrypt RSS encryption which is the which is what my bank everyone's bank uses that's right normal encryption and in the next 5 years is pretty short yes and so several 3 different standards have come out so that encryption professionals can begin putting in tools that can fight against that because you have to start now if you wanna be ready in five years and so this was shocking to me and maybe maybe you've been following hold on it was shocking that the quantum was gonna was gonna work in five years oh oh I I know quantum is gonna destroy our RSA encryption okay okay I was not expecting the next five years yes got it got it okay cause you know I I didn't I didn't know the timeline but the next five years doesn't surprise me and I also know people have been working to counter this because they know it's inevitable yeah it's definitely five years or six years yeah it's it's soon much sooner than I thought yeah I I thought was thinking it was much further away 20 20 years 30 years no no no if if we're gonna put new encryption into our banking system and our credit check system and all our systems we need it takes five years to do that I mean dude every I mean it we're talking SSL we're talking like the ability to transact online yeah we're talking all crypto all cryptocurrency yes I mean quantum breaks all that yes all that so so forget um people having my Social Security number yeah they don't need that no they just go into my bank send themselves money they don't need my Social Security number that's right um and it's really a state like a country risk and so I don't know I I wanted to talk about it and I think it's good that we are coming out with new encryption methodologies that can protect ourselves yes good good and very important yes and also just a reminder that uh staying ahead of of things from a technology perspective is a national security matter yes it's it's like you don't have a choice you've got to invest in this stuff and investing actually means having great immigration policies because you want to be able to import the best brains in the world so that you can stay ahead of everybody else yes that's right and a great VC apparatus and great entrepreneurs and yes great inventors and yes the United States has that and so we just have to keep investing it right we've got the setup to win yeah that's right we just have to try yes yeah so that's good man that was good all right you're around for a while right yeah yeah no more travel I'm here okay good well then I'll see you next week yes